Provider First Line Business Practice Location Address:
150 PROSPECT AVE
Provider Second Line Business Practice Location Address:
SUITE 12
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16323-2542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-437-6188
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/15/2006